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- Associação entre potência muscular mensuradas em diferentes testes de sentar e levantar e a variabilidade do torque em indivíduos idosos : estudo correlacionalPublication . Espadilha, Ana Patrícia dos Santos Pinheiro; Radaelli, RégisIntrodução: A potência dos membros inferiores, avaliada pelo teste de sentar e levantar (STS), e a variabilidade do torque são preditores sensíveis da funcionalidade em idosos. Porém, a relação entre eles em idosos é pouco conhecida. Métodos: Este estudo teve como objetivo analisar a relação entre a potência muscular, mensurada por diferentes testes de STS, e a variabilidade do torque em indivíduos idosos. Neste estudo participaram 38 homens e mulheres idosos saudáveis. Foram mensuradas a contração isométrica máxima dos extensores do joelho num dinamómetro isocinético, e posteriormente mensurada a variabilidade do torque. A potência muscular durante a execução dos testes de STS foi avaliada a partir de três diferentes métodos: com encoder, na plataforma de força e por fórmula. Os participantes realizaram os testes de STS na plataforma de força e com o encoder com repetições lentas e rápidas, enquanto para o cálculo a partir da fórmula os praticantes realizaram o maior número de repetições de sentar e levantar em 30 segundos. Resultados: Foram encontradas correlações significativas positivas entre a variabilidade do torque e a potência absoluta e relativa, medida pelo encoder (R² ≈ 0,17– 0,39; p < 0,001), quando o teste de STS foi executado de maneira lenta e rápida. Também, foi observada corelação significativa entre a variabilidade do torque e a potência avaliada na plataforma de força de forma lenta (R² ≈ 0,12; p < 0,001). Por fim, também foi encontrado correlação significativa entre a variabilidade e a potência obtida pela fórmula (R² ≈ 0,39; p < 0,001). Conclusão: A potência muscular avaliada por diferentes testes de STS, mostraram correlação moderadas e significativas com a variabilidade do torque. Também, sugerem uma maior sensibilidade da relação entre a variabilidade e a potência muscular nos STS avaliada pelo encoder e pela fórmula.
- Comparison of acute cortical drive responses in scapular muscles after scapular-oriented exercises with electromyographic biofeedback or verbal and tactile feedback in healthy young adults : a randomized controlled trialPublication . Ferreira, João Francisco Santos; Neto, Carla MartinhoIntroduction: The scapular muscles are vital for movement and scapulohumeral rhythm. Electromyographic biofeedback and other feedback modalities are effective in enhancing electromyographic activity and motor control. Transcranial Magnetic Stimulation (TMS) assesses cortical plasticity, linking motor adaptations to the corticospinal system. A gap remains in the understanding of the role of cortical reorganization in mediating the effects of Electromyographic biofeedback on motor learning. This study compared the acute cortical drive responses in scapular muscles following exercises with Electromyographic biofeedback or verbal and tactile feedback in healthy young adults, hypothesizing greater responses with Electromyographic biofeedback. Methods: Twelve healthy young adults (aged 18–35) were recruited, all shoulder pain free and with no contraindications to TMS. Participants were randomized into two groups: TMS + Electromyographic biofeedback (BEMG) (n = 5) and TMS + Verbal/Tactile Feedback (AT) (n = 7). Both groups performed a single 30-minute exercise session focused on scapulothoracic muscles. Cortical drive was assessed via TMS, including Corticospinal Excitability (CSE), Silent Period (SP), and Short-Interval Intracortical Inhibition (SICI) of the Upper (UT) and Lower Trapezius (LT) muscles. Results: No significant differences were observed between groups in CSE or SP for either UT or LT. However, a statistically significant difference was found in the percentage change of UT SICI, with the AT group (verbal/tactile feedback) showing a substantially greater increase (mean difference = −64.89%; Cohen’s d = -1.325). For the LT, changes in SP showed a large effect size in favor of the AT group, although not statistically significant. Conclusion: Verbal and Tactile feedback may be effective strategies during the initial phases of scapulothoracic muscle strengthening, potentially facilitating motor learning more efficiently than visual feedback. The SICI results for the UT suggest distinct neuromodulator effects between feedback modalities. These findings should be interpreted with caution due to the small sample size (n = 12) and other methodological limitations. Future studies with larger samples and longer interventions are recommended.
- Comparison of cortical drive and muscle power in older adults with and without fear of falling : a comparative cross-sectional studyPublication . Sousa, Laís Karielly Rodrigues de; Radaelli, RégisIntroduction: Fear of falling (FoF) is a psychological factor that contributes to physical inactivity, social withdrawal, and increased fall risk. Previous evidence suggests age-related changes in cortical drive and muscle power. However, there is a lack of knowledge on how these changes affect FoF. This study aimed to compare corticospinal excitability (CSE), short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), silent period (SP) and lower-limb muscle power between older adults with and without FoF. Methods: Eighteen communitydwelling older adults (g65 years old) participated and were classified into two groups based on the Falls Efficacy Scale International (FES-I): NFoF (score <28; n=10) and FoF (score g28; n=8). Cortical drive was assessed using Transcranial Magnetic Stimulation (TMS), with measures of active motor threshold (AMT), CSE, SICI, ICF. Lower-limb muscle power was measured via countermovement jump on a force platform. Physical activity levels were evaluated using the IPAQ-short form. Results: Groups were similar in age, BMI, and height. Participants with FoF had significantly more falls in the past 12 months (p=0.006). No statistically significant differences were found between groups for AMT (p=0.864), CSE (p=0.565), ICF (p=0.999), SICI (p=0.355) or SP (p=0.667). Physical activity levels did not differ significantly between older adults with and without FoF (p=0.342; §= 0.325). No statistically significant differences were found in absolute or relative muscle power between groups (p=0.141; d=0.735 and p=0.150; d=0.717, respectively). Conclusion: The FoF does not appear to influence neurophysiological parameters or lower-limb muscle power in this sample of older adults.
- Comparison of external load variability in injured and uninjured youth elite football male athletes : a cross-sectional studyPublication . Passos, Fábio Gonçalo Sales; Vaz, João Pedro Casaca de RochaFootball's nature carries a high risk of injury, particularly given the increased amount of hard running and sprinting. This study aims to investigate the external load temporal structure between non-injured and injured football athletes, during a 10-day period prior to the injury event. A sample of 38 male youth elite football players was selected for the study. Information on their external load was gathered throughout a range of durations, and GPS data was used to gauge it. The results from linear GPS variables mean and standard deviation between the two groups weren’t statistically significant. On the other hand, the values from non-linear metrics, such as Detrended Fluctuations Analysis, showed that the alpha from the injured players was significantly lower (0.84±0.03) compared to non-injured players (0.86±0.03, p<0.05). We have observed greater randomness in the temporal structure of injured athletes. This study concludes that integrating these metrics may make GPS technology an even more effective tool for injury prevention and possible daily monitoring. Further research could include combined nonlinear measures with subjective fatigue measures to give a holistic picture of an athlete's condition with a larger sample size and other sports contexts
- Comparison of ground reaction force variability between sprint athletes with and without hamstring injury history : a cross-sectional studyPublication . Feliciano, Margarida Nobre; Oliveira, Paulo Ricardo Miranda; Fernandes, Orlando de Jesus Semedo MendesSprint running exposes the hamstring muscles to high mechanical loads, particularly during the late swing and early stance phases, which are recognized as critical periods of elevated injury risk for this muscle group. In sprinters with a history of hamstring injury (W/HHI), alterations in vertical ground reaction force (vGRF) variability may persist even after rehabilitation, reflecting potential neuromuscular adaptations or constraints. Determining whether this variability falls within a functional range is essential, as both excessive rigidity and instability can compromise performance and increase the risk of reinjury. In this cross-sectional study, 17 sprinters (7 W/HHI, 10 WO/HHI) performed a 60-second submaximal sprint on an instrumented treadmill. VGRF variability was assessed using Sample Entropy (SaEn) and analysis of the force–time relationship (log-log slope). The W/HHI group presented lower mean log-log slope values (0.175 ± 0.342; range from -0.417 to 0.627) compared to the WO/HHI group (0.497 ± 0.546; range from -0.137 to 1.875), although this difference did not reach statistical significance (p = 0.195). A tendency toward lower SaEn values was also observed in the W/HHI group (SaEn_Force: 1.80 ± 0.433 vs. 2.16 ± 0.402; p = 0.103; SaEn_Time: 2.26 ± 0.382 vs. 2.50 ± 0.337; p = 0.219), suggesting distinct motor control profiles. In the W/HHI group, greater variability in force did not compromise responsiveness, which may reflect compensatory motor reorganizations. By contrast, the WO/HHI group demonstrated greater robustness in the force–time relationship but also signs of force instability that appeared to be counterbalanced by temporal variability. These findings underscore the relevance of assessing the temporal structure of vGRF variability in sprinters, as it allows the identification of trends in motor adaptation and reorganization associated with injury history. Moreover, they highlight the importance of integrating neuromuscular re-education programs into physiotherapy and prevention protocols, with the aim of re-establishing functional variability specific to the demands of sprinting, thereby promoting a safe return to performance, optimizing performance and reducing reinjury risk.
- Efeito de um programa multimodal versus goteira oclusaL de 6 semanas na dor, abertura oral e qualidade de vida em adultos com disfunção temporomandibular (DTM) : um ensaio clínico controladoPublication . Mestre, Ana Marta Guerreiro; Alves, Paula MoleirinhoA disfunção temporomandibular (DTM) é uma condição de etiologia multifatorial que acomete a articulação temporomandibular (ATM), os músculos mastigatórios e estruturas associadas, impactando negativamente na qualidade de vida dos pacientes. Este estudo teve como objetivo avaliar e comparar o efeito de um programa multimodal (terapia manual combinada com exercícios terapêuticos) versus goteira oclusal, na modulação da dor, abertura oral e qualidade de vida de saúde oral (QdVRSO) no tratamento de adultos com DTM muscular com limitação da abertura oral durante 6 semanas. O ensaio clínico controlado incluiu 24 participantes com idades compreendidas entre os 18 e 50 anos, divididos em dois grupos experimentais: G1 (realizou um programa multimodal, uma vez por semana durante 30 minutos) e G2 (utilizou goteira oclusal diariamente, durante a noite). Os participantes foram avaliados em dois momentos, inicial e final, quanto à intensidade da dor, amplitude de abertura oral, limiar de tolerância de dor à pressão (PPT) e QdVRSO. Os resultados demonstraram que ambos os grupos obtiveram melhorias significativas na intensidade da dor, amplitude de abertura oral e QdVRSO, destacando a eficácia dessas abordagens conservadoras. O programa multimodal demonstrou superioridade no aumento da amplitude de abertura oral e na melhoria do PPT, enquanto a goteira oclusal apresentou maior eficácia na diminuição da intensidade da dor. A única diferença estatisticamente significativa entre os grupos foi observada no PPT, com melhorias significativas apenas no G1, o que pode indicar que o programa teve um maior contributo para a ativação das vias inibitórias descendentes de modulação da dor. Porém, os resultados demonstram que ambas as intervenções são válidas no tratamento de pacientes com DTM.
- Efeitos de um programa de terapia manual e exercícios terapêutico associados a um programa de exercício aeróbio de 6 semanas na disfunção temporomandibular muscularPublication . Fresco, Ana Catarina Dourado; Alves, Paula MoleirinhoIntrodução: A disfunção temporomandibular (DTM) é uma condição que pode afetar os músculos mastigatórios e conduzir ao aparecimento de dor e à diminuição da qualidade de vida. O objetivo deste estudo é a comparação dos efeitos de um programa de terapia manual e exercícios terapêuticos com um programa de terapia manual e exercícios terapêutico associado a exercício aeróbio de 6 semanas, na intensidade da dor, na amplitude de abertura oral, no limiar de tolerância de dor à pressão, na ansiedade e na qualidade de vida da saúde oral em sujeitos com DTM muscular. Metodologia: Ensaio clínico controlado, com 18 participantes diagnosticados através do Diagnostic Criteria for Temporomandibular Disorders (DC-TMD) com DTM muscular e divididos em dois grupos: G1 (26,8±7,92) com 11 participantes que realizou um programa de terapia manual e exercícios terapêuticos (uma vez por semana durante 30 minutos) e G2 (26,9±6,62) , com 7 participantes que realizou o mesmo programa de G1 (uma vez por semana durante 30 minutos) associado a exercício aeróbio de intensidade moderada (duas vezes por semana durante 30 minutos). Foi avaliada a intensidade da dor através da escala numérica da dor (NPRS), o limiar de tolerância de dor à pressão (PPT) através do algómetro, a amplitude de abertura oral máxima confortável (AMC) e forçada (AMF) através do paquímetro, a ansiedade através da Generalized Anxiety Disorder (GAD-7) e qualidade de vida relacionada com a saúde oral (QdRVSO) através da Oral Health Impact Profile (OHIP-14). O primeiro momento de avaliação (T1) foi realizado antes de se iniciar a intervenção e o segundo momento de avaliação (T2) 48h após o término do programa de 6 semanas. Resultados: Houve uma diminuição significativa da NPRS, um aumento significativo da AMC, AMF e da OHIP-14 em G1 e G2 entre T1 e T2. No PPT verificou-se um aumento significativo no masséter direito (MD) e temporal esquerdo (TE) no G1 e G2, e no masséter esquerdo (ME) e temporal direito (TD) apenas no G2. G1 e G2 apresentaram diferenças significativas no aumento do PPT, com o G2 a obter melhores resultados. Não se verificaram diferenças significativas na GAD-7. Conclusão: O programa de terapia manual e exercícios terapêuticos e o programa de terapia manual e exercícios terapêutico associado a exercício aeróbio conduziram a uma diminuição da dor, aumento de amplitude oral e melhoria da qualidade de vida ao fim de 6 semanas de intervenção. O programa de terapia manual e exercícios terapêutico associado a exercício aeróbio promoveu um maior aumento do limiar de tolerância de dor à pressão.
- The effect of focus of attention during a single bout of resistance exercise on plantarflexion torque complexity and cortical drive in older adults : a randomized controlled trialPublication . Marques, Tiago José Santos; Vaz, João Pedro Casaca de RochaIntroduction: Ageing is accompanied by impairments in neuromuscular function, contributing to reduced force control, increased muscle co-contraction during gait, and diminished adaptability, ultimately increasing the risk of falling. Resistance training and attentional focus strategies have independently been proposed as potential modulators of these deficits, yet their combined effect remains unclear, especially in older adults. The present study investigated how different attentional focus instructions during a single bout of plantarflexion resistance training influence force control and the underlying neurophysiological mechanisms in this population. Methods: 23 participants (≥ 60 years old) were screened and homogeneously randomized into internal, external, or visual (distal) external focus groups after a familiarization session. In the evaluation session, neuromuscular and cortical drive measures were obtained before and after a single standardized seated calf raise resistance training bout. Results: No group-related differences were observed. However, acute pre- to post-training effects emerged across all groups, including reduced maximal force production, increased torque variability (coefficient of variation), and decreased corticospinal inhibition. Torque complexity and intracortical measures remained unchanged. Conclusion: These findings suggest that attentional focus strategies applied during a single resistance training session are not sufficient to modify force control or cortical mechanisms in older adults. Nonetheless, the observed neuromuscular fatigue and corticospinal modulation highlight this population’s acute adaptations to a single resistance training session.
- Effects of attentional focus on torque regulation and muscle activation in acute anterior cruciate ligament injured individualsPublication . Filipe, Hugo Manuel dos Santos; Vaz, João Pedro Casaca de RochaAttentional focus has been extensively studied in the context of motor learning, demonstrating a significant influence on movement execution and control. However, its effects in populations with anterior cruciate ligament (ACL) injury, particularly regarding torque variability and muscle activation, remain underexplored. This study aimed to examine the effects of different attentional focus strategies (internal vs. external) on torque production and electromyographic activity in athletes with ACL injuries. Eleven participants with ACL injuries performed submaximal isometric knee contractions under internal or external focus instructions, using an isokinetic dynamometer. Variables such as sample entropy (SampEn), torque coefficient of variation (CV), co-contraction index (CCI), and electromyographic activity of the vastus lateralis and biceps femoris were analyzed. Results revealed no statistically significant differences in torque variability between conditions; however, higher levels of co-contraction and hamstring activation were observed under the external focus condition. These findings suggest that attentional focus may modulate motor control patterns in individuals with ACL injuries by influencing neuromuscular compensation strategies throughout rehabilitation. Thoughtful implementation of attentional focus instructions may serve as a valuable component in the optimization of exercise-based rehabilitation protocols.
- The effects of neck pain on postural control variability in dental medicine students : a longitudinal studyPublication . Vieira, Sofia de Oliveira; Almeida, Manuel João Videira da Silva Barbosa deNeck pain is a common complaint among dental medicine students, resulting from sustained postures during clinical practice and potentially compromising postural control. However, the longitudinal effects of neck pain on postural control variability remain underexplored. This study aimed to analyze how the presence of neck pain influences postural control variability in dental medicine students over the course of three semesters of clinical training. Forty-four students initially participated in the study and were divided into two groups— with and without neck pain—based on the Nordic Musculoskeletal Questionnaire. Postural control was assessed using a force platform across eight distinct postural conditions, considering both anteroposterior and mediolateral components. Postural control variability was quantified using SampEn, calculated via a customized MATLAB script. Data were analyzed through a linear mixed-effects model, with fixed factors including group, time, postural position, cervical rotation, and visual condition. Results revealed that, over time, the neck pain group showed a progressive reduction in postural variability, reflecting a more rigid control pattern, especially under more demanding tasks such as tandem stance with eyes closed. These findings suggest that neck pain negatively affects the students’ ability to adapt posturally, highlighting the need for preventive strategies in academic and clinical settings.